Organization Active NPI

Montgomery Otolaryngology LLP

  • Otolaryngology Physician
  • Montgomery, AL
National Provider Identifier
1497865893
Registry record updated Apr 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
MONTGOMERY OTOLARYNGOLOGY LLP
Practice address
1722 Pine St
Suite 804
Montgomery, AL 36106-1103
Phone
(334) 834-7221
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Rodger Egeland, MPH
Title
Administrator
Phone
(334) 834-7221

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

1722 Pine St
Suite 804
Montgomery, AL 36106-1103

Mailing address

1722 Pine St
Suite 804
Montgomery, AL 36106-1103
Phone (334) 834-7221

Other identifiers 2

IdentifierTypeStateIssuer
528801560MedicaidAL
D507OtherALMEDICARE PTAN

National Provider Directory

National Provider Directory

Locations

2055 E South Blvd
Ste 810
Montgomery, AL 36116

1111 Olive St
Montgomery, AL 36106
Phone (334) 293-8888

645 McQueen Smith Rd N
Ste 206
Prattville, AL 36066
Phone (334) 358-4200

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302566400000",
    "number": "1497865893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 PINE ST",
            "address_2": "SUITE 804",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061103",
            "telephone_number": "334-834-7221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 PINE ST",
            "address_2": "SUITE 804",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061103",
            "telephone_number": "334-834-7221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY OTOLARYNGOLOGY LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2011-04-12",
        "status": "A",
        "authorized_official_last_name": "EGELAND",
        "authorized_official_first_name": "RODGER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "334-834-7221",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPH"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528801560",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "D507",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.